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Clinical-Biological Assessment of Prosthetic Field Following Pre-Prosthetic Phase Related to Prosthetic Treatment Solutions. 与假体治疗方案相关的预假体阶段后假体场的临床生物学评估。
IF 2.2
Clinics and Practice Pub Date : 2025-07-26 DOI: 10.3390/clinpract15080140
Petruţa Siminiuc, Doriana Agop-Forna, Cristina Dascălu, Norina Forna
{"title":"Clinical-Biological Assessment of Prosthetic Field Following Pre-Prosthetic Phase Related to Prosthetic Treatment Solutions.","authors":"Petruţa Siminiuc, Doriana Agop-Forna, Cristina Dascălu, Norina Forna","doi":"10.3390/clinpract15080140","DOIUrl":"10.3390/clinpract15080140","url":null,"abstract":"<p><p><b>Background</b>. Extensive partial edentulism alters the biological and functional balance of the stomatognathic system, requiring targeted pre-prosthetic procedures to optimize treatment outcomes. <b>Objectives</b>. The aim of this study was to assess the extent of improvement in the clinical-biological scores of the prosthetic field in patients with extensive edentulism, following pre-prosthetic interventions. <b>Materials and Method</b>. This prospective, cross-sectional study investigated 194 subjects with extensive partial edentulism. Clinical-biological scores, initially and following the pre-prosthetic phase, were recorded using a scoring system that evaluated dental and periodontal status, bone and mucosal support, occlusion, and mandibulo-cranial relationships. Statistical comparisons of clinical-biological scores were related to the type of prosthetic therapy. Statistical significance was considered at a <i>p</i>-value < 0.05. <b>Results</b>. There was an overall significant improvement in the clinical-biological scores initially (mean value 20.2) and after pre-prosthetic procedures (mean value 23.22) (<i>p</i> < 0.001). When treatment groups were divided, the implant-assisted prosthesis group showed the best improvement in all domains, followed by the conventional fixed-prostheses group (<i>p</i> < 0.01). Dental support improved significantly in those with semi-rigid composite prostheses (<i>p</i> = 0.014), while periodontal support was improved in both fixed- and hybrid-implant groups. Mucosal and bone support improved mostly in the fixed-implant groups (<i>p</i> = 0.014). <b>Conclusions</b>. Pre-prosthetic procedures significantly enhance the biological and functional readiness of the prosthetic field, with the degree of improvement influenced by the complexity and type of planned prosthetic rehabilitation. The findings underscore the value of individualized pre-prosthetic protocols as an essential component of prosthetic treatment planning.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Hydrodilatation at Different Volumes on Adhesive Capsulitis in Phases 1 and 2: Clinical Trial Protocol HYCAFVOL. 不同体积的水扩张对1期和2期粘连性囊炎的影响:临床试验方案HYCAFVOL。
IF 2.2
Clinics and Practice Pub Date : 2025-07-26 DOI: 10.3390/clinpract15080141
Javier Muñoz-Paz, Ana Belén Jiménez-Jiménez, Francisco Espinosa-Rueda, Amin Wahab-Albañil, María Nieves Muñoz-Alcaraz, José Peña-Amaro, Fernando Jesús Mayordomo-Riera
{"title":"Effects of Hydrodilatation at Different Volumes on Adhesive Capsulitis in Phases 1 and 2: Clinical Trial Protocol HYCAFVOL.","authors":"Javier Muñoz-Paz, Ana Belén Jiménez-Jiménez, Francisco Espinosa-Rueda, Amin Wahab-Albañil, María Nieves Muñoz-Alcaraz, José Peña-Amaro, Fernando Jesús Mayordomo-Riera","doi":"10.3390/clinpract15080141","DOIUrl":"10.3390/clinpract15080141","url":null,"abstract":"<p><p><b>Background</b>: Adhesive capsulitis (AC) causes a global limitation of both active and passive range of motion (ROM) in the shoulder, with or without pain, and no specific radiographic findings. Its course is self-limiting and progresses through three or four stages. The diagnosis is primarily clinical, since imaging tests are nonspecific. Treatment options include physical therapy (PT), intra-articular corticosteroid injections, suprascapular nerve block (SSNB), and hydrodilatation (HD). The latter is useful for expanding and reducing inflammation of the joint capsule through the insufflation of saline solution, anesthetics, and corticosteroids. <b>Objectives</b>: To compare whether patients with AC, stratified by phase 1 and 2, who receive high-volume HD as treatment achieve better outcomes in terms of shoulder pain and function compared to patients who receive low-volume HD. To compare whether there are differences in PT times and to determine mean axillary recess (AR) values. <b>Methods</b>: A randomized, parallel-block, triple-blind clinical trial will be conducted in 64 patients with AC in phases 1 and 2, aged 30 to 70 years, with limited active and passive ROM in two planes, and shoulder pain lasting more than 3 months. HD will be administered with volumes of 20 mL or 40 mL, followed by a conventional rehabilitation program. Outcomes will be reviewed at the 1st, 3rd, and 6th months of HD. Variables collected will include Shoulder Pain and Disability Index (SPADI), Visual Analog Scale (VAS), Range of motion (ROM), Lattinen index (LI), AR size, and time to completion of PT. <b>Results</b>: HD has been gaining clinical relevance in interventional rehabilitation as a treatment for AC, although its medium- and long-term efficacy remains a matter of debate. The variability in the volumes used for capsular expansion, with studies ranging from 18 mL to 47 mL, is compounded by the fact that most of these studies do not differentiate between AC stages. This could influence treatment effectiveness. Furthermore, diagnosis remains a challenge since valid and specific diagnostic parameters are lacking. <b>Conclusions</b>: Understanding the differences between HD techniques, considering the influence of certain factors such as the volume used or the stages of AC, as well as improving diagnosis and the coordination of scientific work. This could facilitate the development of protocols for the use of HD in AC.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manganese-Based Contrast Agents as Alternatives to Gadolinium: A Comprehensive Review. 锰基造影剂作为钆的替代品:综述。
IF 2.2
Clinics and Practice Pub Date : 2025-07-25 DOI: 10.3390/clinpract15080137
Linda Poggiarelli, Caterina Bernetti, Luca Pugliese, Federico Greco, Bruno Beomonte Zobel, Carlo A Mallio
{"title":"Manganese-Based Contrast Agents as Alternatives to Gadolinium: A Comprehensive Review.","authors":"Linda Poggiarelli, Caterina Bernetti, Luca Pugliese, Federico Greco, Bruno Beomonte Zobel, Carlo A Mallio","doi":"10.3390/clinpract15080137","DOIUrl":"10.3390/clinpract15080137","url":null,"abstract":"<p><strong>Background/objectives: </strong>Magnetic resonance imaging (MRI) is a powerful, non-invasive diagnostic tool capable of capturing detailed anatomical and physiological information. MRI contrast agents enhance image contrast but, especially linear gadolinium-based compounds, have been associated with safety concerns. This has prompted interest in alternative contrast agents. Manganese-based contrast agents offer a promising substitute, owing to manganese's favorable magnetic properties, natural biological role, and strong T1 relaxivity. This review aims to critically assess the structure, mechanisms, applications, and challenges of manganese-based contrast agents in MRI.</p><p><strong>Methods: </strong>This review synthesizes findings from preclinical and clinical studies involving various types of manganese-based contrast agents, including small-molecule chelates, nanoparticles, theranostic platforms, responsive agents, and controlled-release systems. Special attention is given to pharmacokinetics, biodistribution, and safety evaluations.</p><p><strong>Results: </strong>Mn-based agents demonstrate promising imaging capabilities, with some achieving relaxivity values comparable to gadolinium compounds. Targeted uptake mechanisms, such as hepatocyte-specific transport via organic anion-transporting polypeptides, allow for enhanced tissue contrast. However, concerns remain regarding the in vivo release of free Mn<sup>2+</sup> ions, which could lead to toxicity. Preliminary toxicity assessments report low cytotoxicity, but further comprehensive long-term safety studies should be carried out.</p><p><strong>Conclusions: </strong>Manganese-based contrast agents present a potential alternative to gadolinium-based MRI agents pending further validation. Despite promising imaging performance and biocompatibility, further investigation into stability and safety is essential. Additional research is needed to facilitate the clinical translation of these agents.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Physical Activity During Chemotherapy and/or Immunotherapy for Non-Small Cell Lung Cancer (NSCLC): Protocol of the APACHIE-01 Study. 评估非小细胞肺癌(NSCLC)化疗和/或免疫治疗期间的身体活动:APACHIE-01研究方案
IF 2.2
Clinics and Practice Pub Date : 2025-07-25 DOI: 10.3390/clinpract15080139
Dirk Rades, Laura Doehring, Christian Staackmann, Maria Karolin Streubel, Stefan Janssen, Tobias Bartscht, Sabine Bohnet
{"title":"Assessment of Physical Activity During Chemotherapy and/or Immunotherapy for Non-Small Cell Lung Cancer (NSCLC): Protocol of the APACHIE-01 Study.","authors":"Dirk Rades, Laura Doehring, Christian Staackmann, Maria Karolin Streubel, Stefan Janssen, Tobias Bartscht, Sabine Bohnet","doi":"10.3390/clinpract15080139","DOIUrl":"10.3390/clinpract15080139","url":null,"abstract":"<p><strong>Background/objectives: </strong>Most patients with non-small cell lung cancer (NSCLC) receive chemo- and/or immunotherapy, which can be associated with adverse events including fatigue. Affected patients may not be able to receive the complete chemo- and/or immunotherapy as planned. In this context, patients may benefit from maintaining their physical activity, which can be challenging. An app reminding patients to perform a certain number of steps may have a positive effect on physical activity during chemo- and/or immunotherapy. Such an app is under development and will be tested in a prospective trial. The current APACHIE-01 study (NCT06993896) is required for proper sample size calculation and design of the planned trial.</p><p><strong>Methods: </strong>The main goal of the APACHIE-01 study is to evaluate patterns and predictors of physical activity during chemo- and/or immunotherapy for locally advanced or metastatic NSCLC. The primary endpoint is the assessment of the mean number of steps per week during the first three cycles of chemo- and/or immunotherapy for lung cancer. The baseline value is represented by the mean number of steps during the last week prior to chemotherapy and/or immunotherapy. Secondary endpoints include associations between mean number of steps per week and a pain score, a distress score, and a fatigue score. The recruitment of the required 38 patients should be completed within 4 months and the treatment period will be 9-10 weeks (three cycles of chemo- and/or immunotherapy), resulting in a total running time of approximately 6 months. The APACHIE-01 study will contribute to the optimal design of a subsequent prospective trial.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial Intelligence in Primary Care: Support or Additional Burden on Physicians' Healthcare Work?-A Qualitative Study. 初级保健中的人工智能:对医生医疗保健工作的支持还是额外负担?-定性研究。
IF 2.2
Clinics and Practice Pub Date : 2025-07-25 DOI: 10.3390/clinpract15080138
Stefanie Mache, Monika Bernburg, Annika Würtenberger, David A Groneberg
{"title":"Artificial Intelligence in Primary Care: Support or Additional Burden on Physicians' Healthcare Work?-A Qualitative Study.","authors":"Stefanie Mache, Monika Bernburg, Annika Würtenberger, David A Groneberg","doi":"10.3390/clinpract15080138","DOIUrl":"10.3390/clinpract15080138","url":null,"abstract":"<p><p><b>Background</b>: Artificial intelligence (AI) is being increasingly promoted as a means to enhance diagnostic accuracy, to streamline workflows, and to improve overall care quality in primary care. However, empirical evidence on how primary care physicians (PCPs) perceive, engage with, and emotionally respond to AI technologies in everyday clinical settings remains limited. Concerns persist regarding AI's usability, transparency, and potential impact on professional identity, workload, and the physician-patient relationship. <b>Methods</b>: This qualitative study investigated the lived experiences and perceptions of 28 PCPs practicing in diverse outpatient settings across Germany. Participants were purposively sampled to ensure variation in age, practice characteristics, and digital proficiency. Data were collected through in-depth, semi-structured interviews, which were audio-recorded, transcribed verbatim, and subjected to rigorous thematic analysis employing Mayring's qualitative content analysis framework. <b>Results</b>: Participants demonstrated a fundamentally ambivalent stance toward AI integration in primary care. Perceived advantages included enhanced diagnostic support, relief from administrative burdens, and facilitation of preventive care. Conversely, physicians reported concerns about workflow disruption due to excessive system prompts, lack of algorithmic transparency, increased cognitive and emotional strain, and perceived threats to clinical autonomy and accountability. The implications for the physician-patient relationship were seen as double-edged: while some believed AI could foster trust through transparent use, others feared depersonalization of care. Crucial prerequisites for successful implementation included transparent and explainable systems, structured training opportunities, clinician involvement in design processes, and seamless integration into clinical routines. <b>Conclusions</b>: Primary care physicians' engagement with AI is marked by cautious optimism, shaped by both perceived utility and significant concerns. Effective and ethically sound implementation requires co-design approaches that embed clinical expertise, ensure algorithmic transparency, and align AI applications with the realities of primary care workflows. Moreover, foundational AI literacy should be incorporated into undergraduate health professional curricula to equip future clinicians with the competencies necessary for responsible and confident use. These strategies are essential to safeguard professional integrity, support clinician well-being, and maintain the humanistic core of primary care.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Mixed-Methods Case Report on Oral Health Changes and Patient Perceptions and Experiences Following Treatment at the One Smile Research Program: A 2-Year Follow-Up. 一个微笑研究项目治疗后口腔健康变化、患者感知和经历的混合方法病例报告:2年随访。
IF 2.2
Clinics and Practice Pub Date : 2025-07-23 DOI: 10.3390/clinpract15080136
Mona Abdelrehim, ZhuZhen Hellen Huang, Christiana Martine, Imon Pal, Kamini Kaura, Anuj Aggarwal, Sonica Singhal
{"title":"A Mixed-Methods Case Report on Oral Health Changes and Patient Perceptions and Experiences Following Treatment at the One Smile Research Program: A 2-Year Follow-Up.","authors":"Mona Abdelrehim, ZhuZhen Hellen Huang, Christiana Martine, Imon Pal, Kamini Kaura, Anuj Aggarwal, Sonica Singhal","doi":"10.3390/clinpract15080136","DOIUrl":"10.3390/clinpract15080136","url":null,"abstract":"<p><p><b>Background</b>: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. <b>Clinical Case</b>: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. <b>Results</b>: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. <b>Conclusions</b>: The continuity of cost-free dental care effectively addressed the participant's oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Responders to Cervical Facet Platelet-Rich Plasma Demonstrate Synergistic Improvements in Pain and Isometric Strength in Chronic Whiplash-Associated Disorders: A Series of Mediation Analyses. 对颈椎小关节富血小板血浆的反应显示慢性鞭伤相关疾病的疼痛和等长强度的协同改善:一系列中介分析。
IF 2.2
Clinics and Practice Pub Date : 2025-07-23 DOI: 10.3390/clinpract15080135
Ashley D Smith, Benjamin Andruski, George Deng, Colin Bouma, Marc Pesant, Fiona Magill, Robert Burnham
{"title":"Responders to Cervical Facet Platelet-Rich Plasma Demonstrate Synergistic Improvements in Pain and Isometric Strength in Chronic Whiplash-Associated Disorders: A Series of Mediation Analyses.","authors":"Ashley D Smith, Benjamin Andruski, George Deng, Colin Bouma, Marc Pesant, Fiona Magill, Robert Burnham","doi":"10.3390/clinpract15080135","DOIUrl":"10.3390/clinpract15080135","url":null,"abstract":"<p><strong>Background/objectives: </strong>Platelet-rich plasma (PRP) is emerging as a safe and effective treatment for facet-mediated pain. Studies have demonstrated reductions in pain and improvements in function, both in the short (3 months) and longer term (6 and 12 months). The mechanisms underlying clinical improvements are largely unknown. It is also unclear whether reported outcomes are due to the PRP administered or concurrently applied rehabilitation.</p><p><strong>Methods: </strong>A prospective case series was conducted in a single, multidisciplinary chronic pain centre. Forty-two participants with chronic WAD and cervical facet-mediated pain who received PRP (64% female; mean age (SD) 42.8 (11.6) years; median WAD duration [IQR] 23 [18,29] mths), attended rehabilitation, and reported successful outcomes 3 months post-PRP fulfilled the inclusion criteria. Measures of pain, cervical isometric strength, and range of motion were collected at baseline and 3 months post-PRP. Mediation analyses were performed to determine how these factors influenced disability.</p><p><strong>Results: </strong>Participants demonstrated clinically significant and relevant improvements in pain, disability, and isometric strength measures (all <i>p</i> < 0.01). Causative mediation analyses demonstrated independent direct, but not indirect, effects of both pain and strength on disability (both <i>p</i> < 0.001), with no direct or indirect effects of cervical ROM on disability.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanical and Biological Complications Two Years After Full-Arch Implant-Supported Prosthetic Rehabilitation: A Retrospective Clinical Study. 全弓种植体康复后2年的机械和生物学并发症:回顾性临床研究。
IF 2.2
Clinics and Practice Pub Date : 2025-07-18 DOI: 10.3390/clinpract15070134
Denisa Tabita Sabău, Petra Saitos, Rahela Tabita Moca, Raluca Iulia Juncar, Mihai Juncar
{"title":"Mechanical and Biological Complications Two Years After Full-Arch Implant-Supported Prosthetic Rehabilitation: A Retrospective Clinical Study.","authors":"Denisa Tabita Sabău, Petra Saitos, Rahela Tabita Moca, Raluca Iulia Juncar, Mihai Juncar","doi":"10.3390/clinpract15070134","DOIUrl":"10.3390/clinpract15070134","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Full-arch implant-supported prostheses have become a widely accepted solution for edentulous patients, yet long-term biological and mechanical complications remain a clinical concern. <b>Methods</b>: This retrospective study included 70 fully edentulous patients (362 implants) rehabilitated with either fixed or removable implant-supported prostheses. Data were collected on demographics, medical status, type and location of prostheses, implant type, abutments, method of fixation, and complications. Statistical analysis included Fisher's exact test, the Mann-Whitney U test, and chi-squared tests, with a significance level set at <i>p</i> < 0.05. <b>Results</b>: Mechanical complications occurred in 41.4% of patients (29 out of 70), with framework fractures reported in eight cases (27.6%), ceramic chipping in six cases (20.7%), and resin discoloration in four cases (13.8%). The prostheses were fabricated using monolithic zirconia, metal-ceramic crowns, zirconia on titanium bars, and hybrid resin/PMMA on cobalt-chromium frameworks. Gingival inflammation was also noted in 41.4% of cases (<i>n</i> = 29), predominantly in posterior implant regions. Younger patients and those without systemic diseases showed a significantly higher incidence of mechanical complications. <b>Conclusions</b>: Two years post-treatment, mechanical and biological complications appear to be independent phenomena, not significantly associated with most prosthetic variables. Patient-specific factors, particularly age and general health status, may have greater predictive value than prosthetic design. Limitations of the study include its retrospective design and the lack of radiographic data to assess peri-implant bone changes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing Multivariable Logistic Regression for Identifying Perioperative Risk Factors for Deep Brain Stimulator Explantation: A Pilot Study. 优化多变量Logistic回归识别深部脑刺激器移植围手术期危险因素:一项初步研究。
IF 2.2
Clinics and Practice Pub Date : 2025-07-17 DOI: 10.3390/clinpract15070132
Peyton J Murin, Anagha S Prabhune, Yuri Chaves Martins
{"title":"Optimizing Multivariable Logistic Regression for Identifying Perioperative Risk Factors for Deep Brain Stimulator Explantation: A Pilot Study.","authors":"Peyton J Murin, Anagha S Prabhune, Yuri Chaves Martins","doi":"10.3390/clinpract15070132","DOIUrl":"10.3390/clinpract15070132","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Deep brain stimulation (DBS) is an effective surgical treatment for Parkinson's Disease (PD) and other movement disorders. Despite its benefits, DBS explantation occurs in 5.6% of cases, with costs exceeding USD 22,000 per implant. Traditional statistical methods have struggled to identify reliable risk factors for explantation. We hypothesized that supervised machine learning would more effectively capture complex interactions among perioperative factors, enabling the identification of novel risk factors. <b>Methods</b>: The Medical Informatics Operating Room Vitals and Events Repository was queried for patients with DBS, adequate clinical data, and at least two years of follow-up (<i>n</i> = 38). Fisher's exact test assessed demographic and medical history variables. Data were analyzed using Anaconda Version 2.3.1. with pandas, numpy, sklearn, sklearn-extra, matplotlin. pyplot, and seaborn. Recursive feature elimination with cross-validation (RFECV) optimized factor selection was used. A multivariate logistic regression model was trained and evaluated using precision, recall, F1-score, and area under the curve (AUC). <b>Results</b>: Fisher's exact test identified chronic pain (<i>p</i> = 0.0108) and tobacco use (<i>p</i> = 0.0026) as risk factors. RFECV selected 24 optimal features. The logistic regression model demonstrated strong performance (precision: 0.89, recall: 0.86, F1-score: 0.86, AUC: 1.0). Significant risk factors included tobacco use (OR: 3.64; CI: 3.60-3.68), primary PD (OR: 2.01; CI: 1.99-2.02), ASA score (OR: 1.91; CI: 1.90-1.92), chronic pain (OR: 1.82; CI: 1.80-1.85), and diabetes (OR: 1.63; CI: 1.62-1.65). <b>Conclusions</b>: Our study suggests that supervised machine learning can identify risk factors for early DBS explantation. Larger studies are needed to validate our findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Associations Between Sociodemographic and Clinical Factors and Edentulism Complications in Patients Scheduled for Hybrid Prosthetic Therapy: A Cross-Sectional Study. 评估社会人口学和临床因素与混合修复治疗患者牙髓并发症之间的关系:一项横断面研究。
IF 2.2
Clinics and Practice Pub Date : 2025-07-17 DOI: 10.3390/clinpract15070133
Shokraei Gholamreza, Doriana Agop-Forna, Cristina Dascălu, Norina Forna
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